Contract Pharmacy Details

HEALTHYRX PHARMACY LLC
STD336091 Aum International Foundation, Inc.

Covered Entity Details

Entity Name

Aum International Foundation, Inc.

Subdivision Name

GBID

Type

Sexually Transmitted Diseases

340B ID

STD336091

Entity Address

4129 West Kennedy Blvd
2
Tampa, FL 33609

Grant Number

5H25PS004342

Participating Start Date

8/3/2020

Last Recertification Date

5/7/2021

Entity Termination Date

4/1/2022

Pharmacy Details

Pharmacy Name

HEALTHYRX PHARMACY LLC

Pharmacy Address

DBA-HEALTHYRX PHARMACY
650 NW 120TH ST
NORTH MIAMI, FL 33168

Pharmacy Comments

Contract Details

Approval Date

8/3/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2022
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Ganesh Ramachandran, President
(407) 970-5253

Contract Pharmacy Representative

HealthyRx Pharmacy
Ajay Kolla, President
(352) 598-9828

Signed By Date

7/13/2020

340B Drug Pricing Program Database